• Title/Summary/Keyword: employment insurance

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Poor People and Poor Health: Examining the Mediating Effect of Unmet Healthcare Needs in Korea

  • Kim, Youngsoo;Kim, Saerom;Jeong, Seungmin;Cho, Sang Guen;Hwang, Seung-sik
    • Journal of Preventive Medicine and Public Health
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    • v.52 no.1
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    • pp.51-59
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    • 2019
  • Objectives: The purpose of this study was to estimate the mediating effect of subjective unmet healthcare needs on poor health. The mediating effect of unmet needs on health outcomes was estimated. Methods: Cross-sectional research method was used to analyze Korea Health Panel data from 2011 to 2015, investigating the mediating effect for each annual dataset and lagged dependent variables. Results: The magnitude of the effect of low income on poor health and the mediating effect of unmet needs were estimated using age, sex, education level, employment status, healthcare insurance status, disability, and chronic disease as control variables and self-rated health as the dependent variable. The mediating effect of unmet needs due to financial reasons was between 14.7% to 32.9% of the total marginal effect, and 7.2% to 18.7% in lagged model. Conclusions: The fixed-effect logit model demonstrated that the existence of unmet needs raised the likelihood of poor self-rated health. However, only a small proportion of the effects of low income on health was mediated by unmet needs, and the results varied annually. Further studies are necessary to search for ways to explain the varying results in the Korea Health Panel data, as well as to consider a time series analysis of the mediating effect. The results of this study present the clear implication that even though it is crucial to address the unmet needs, but it is not enough to tackle the income related health inequalities.

A Scoping Review of Components of Physician-induced Demand for Designing a Conceptual Framework

  • Mohammadshahi, Marita;Yazdani, Shahrooz;Olyaeemanesh, Alireza;Sari, Ali Akbari;Yaseri, Mehdi;Sefiddashti, Sara Emamgholipour
    • Journal of Preventive Medicine and Public Health
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    • v.52 no.2
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    • pp.72-81
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    • 2019
  • Objectives: The current study presents a new conceptual framework for physician-induced demand that comprises several influential components and their interactions. Methods: This framework was developed on the basis of the conceptual model proposed by Labelle. To identify the components that influenced induced demand and their interactions, a scoping review was conducted (from January 1980 to January 2017). Additionally, an expert panel was formed to formulate and expand the framework. Results: The developed framework comprises 2 main sets of components. First, the supply side includes 9 components: physicians' incentive for pecuniary profit or meeting their target income, physicians' current income, the physician/population ratio, service price (tariff), payment method, consultation time, type of employment of physicians, observable characteristics of the physician, and type and size of the hospital. Second, the demand side includes 3 components: patients' observable characteristics, patients' non-clinical characteristics, and insurance coverage. Conclusions: A conceptual framework that can clearly describe interactions between the components that influence induced demand is a critical step in providing a scientific basis for understanding physicians' behavior, particularly in the field of health economics.

New DNA of the Korean welfare state: Towards social liberalism and freecurity (한국 복지국가의 새로운 DNA: 사회적 자유주의와 자유안정성을 향하여)

  • Choi, Young Jun
    • 한국사회정책
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    • v.25 no.4
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    • pp.39-67
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    • 2018
  • The Korean welfare state has achieved remarkable development during the last two decades, but simultaneously we have witnessed growing prevalent social conflicts and exclusion in the society. This research argues that the source of current problems lies in the nature of the Korean welfare regime, so called, 'paternalistic liberalism'. The paternalistic liberalism has been formulated by the combination of legacies of the developmental state and neo-liberalism. Paternalism with the growth-oriented and employment-centered approach has been a significant factor to restrict individuals' freedom and happiness in the Korean welfare state. It has also been embedded in the Korean welfare state such as social insurance, workfare programs, and centralized social services. In this context, this research proposes social liberalism, pursuing real freedom for all, as a new paradigm for the Korean welfare state. Breaking from the old path, Freecurity, combining freedom and security, which is argued to be the upgraded version of flexicurity, is also newly proposed as the operating model of social liberalism.

Comparative Study of Clinical Features between Early- and Late-Onset Schizophrenia in South Korea (조기 발병 조현병과 후기 발병 조현병의 임상 양상에 대한 비교 연구)

  • Ko, Mi-Ae;Lee, Seon-Koo;Lee, Jung Suk
    • Korean Journal of Schizophrenia Research
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    • v.22 no.2
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    • pp.51-55
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    • 2019
  • Objectives: Late-onset schizophrenia (LOS, age at first onset ≥40 years) is characterized by including predominance of women, better premorbid social adjustment and lower severity of positive/negative symptoms. However, few studies have been conducted on LOS, especially in Asian countries. This study aimed to examine the clinical features of LOS in comparison with early-onset schizophrenia (EOS). Methods: By retrospectively reviewing medical records, we assessed demographic data and clinical features of 76 LOS (20 males) and 357 EOS (144 males) who admitted to the psychiatric ward of a general hospital. Results: The mean ages of onset were 47.3±5.1 (LOS) and 25.7±6.5 (EOS) years. There were significantly more women in LOS (73.7%) than EOS (59.6%). Significantly more LOS patients had a marital (88.2% vs. 25.8%) and employment history (28.9% vs. 13.1%) than EOS. Patients with LOS had fewer negative (14.3±9.0 vs. 19.9±9.3), general psychopathology score (36.9±11.1 vs. 42.3±13.9) than EOS patients. Conclusion: In line with previous studies, this study demonstrated that LOS patients have better premorbid social adjustment. Our finding also replicates previous findings that LOS patients differ from EOS in predominance of women and relative lack of negative symptoms. These results suggest that LOS may be a distinct subtype of schizophrenia.

The Influencing Factors of Subjective Health and Health-Related Quality of Life in Middle-Aged Women (중년여성의 주관적 건강 및 건강관련 삶의 질 영향요인)

  • Park, Hye-Seon;Kim, Sang-Mi
    • The Journal of the Convergence on Culture Technology
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    • v.10 no.3
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    • pp.121-130
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    • 2024
  • This study utilized data from 1,068 women aged 40-59, drawn from the 8th Korea National Health and Nutrition Examination Survey (KNHANES) conducted in 2020, to investigate factors impacting subjective health perception and health-related quality of life. Methodologically, STATA 15.0 was employed for complex sample mean and standard deviation calculations, complex sample weighted percentages, complex sample t-tests, and multiple regression analyses. Common factors influencing both subjective health and health-related quality of life included education level, household size, depression, and stress. Age, binge drinking, and physical activity were identified as factors influencing subjective health perception. Insurance type, employment status, and sleep disorders emerged as factors impacting health-related quality of life. Recognizing middle age as a crucial transitional phase into old age, the development of health policy programs aimed at enhancing subjective health and health-related quality of life during this period is deemed essential.

Elementary School Dietitian's Awareness and Performance of Food Supply Management in Gyeonggi North Province (경기 북부 지역 초등학교 영양사의 식자재 공급관리에 대한 인식도 및 실천도)

  • Eo, Geum-Hee;Park, Young-Sim
    • The Korean Journal of Food And Nutrition
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    • v.21 no.4
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    • pp.562-571
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    • 2008
  • The principal objective of this study was to assess dietitian's awareness and performance with regard to food suppliers' selection guidelines and purchase guidelines for the receipt of safe food materials. A questionnaire was administered to 203 dietitians working at an elementary school in Gyeonggi North province, and 190 responses were ultimately returned. Excluding responses with incomplete answers and significant missing data, 161 responses(79.3%) were ultimately utilized for data analysis. We determined that meat/poulty and seafood were purchased mainly by manufacturer's branch(59.8% and 78.3%), and processed food and kimchi were generally purchased by producer's cooperatives(47.7% and 44.9%). 78.3% of the contracts were made via informal purchasing and the frequency of contracts was less than 3 times per year(53.4%). Market studies were conducted individually(54.7%), and by group(47.2%). Dietitian and parents volunteered(50.3%) or dietitians, and school and foodservice staffs(45.3%) participated - together in receiving and inspection. School contracted with $4{\sim}5$(39.1%) and $6{\sim}8$ food suppliers(29.8%). Dietitians(42.3%) or school councils(40.2%) evaluated food suppliers once per semester(60.2%). The majority of dietitians(96.3%) conducted sanitary education for food suppliers once per semester (68.3%). All 13 guidelines which were usually used to evaluate food suppliers were thought to be important(more than 4) based on a 5 scale(1: never important, 5: very important). Among them, 'sanitary storage status of food products(4.85)', 'have a chill car(4.83)' and 'proper control of refrigerator, freezer and storage room(4.81)' were the most crucial guidelines. As dietitians evaluated food supplier's-observances of 13 guidelines, 'have a chill car(4.89)', 'hold medical examination of employees(4.89)' and 'hold liability insurance for handling product(4.80)' were fulfilled relatively well. The guidelines for conducting education for their employees(4.45) and keeping their establishment and equipment sanitary(4.79) were important, but were not observed well(3.39 and 3.37). Additionally, the difference between the importance and the observance score of the 'HACCP certificate' were fairly significant(4.44 and 3.54). Dietitians tended to report that purchasing management related to the removal of foodborne illness factors(4.71), return confirmation(4.50) and purchase specification(4.32) were important. The difference between importance and performance was highest in the process of changing food suppliers when the contracts were violated more than three times. Dietitian's age, education work experience and employment type had no observable effects on how important they considered purchase management to be, but their work experience significantly affected performance in terms of the removal of foodborne illness factors(p<0.05). As supplier management is the most critical factor, it is clearly desirable to educate suppliers at specialized training centers and to supervise suppliers in accordance with the established sanitary guidelines.

A Study on Comparison of Commercial Arbitration System in Korea and U.S.A. (한국과 미국의 상사중재제도에 관한 비교연구)

  • 이강빈
    • Journal of Arbitration Studies
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    • v.12 no.1
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    • pp.271-321
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    • 2002
  • Every year, many million of business transactions take place. Ocassionally, disagreements develop over these business transactions. Many of these disputes are resolved by mediation, arbitration and out-of-court settlement options. The American Arbitration Association(AAA) helps resolve a wide range of disputes through mediation, arbitration, elections and other out-of-court settlement procedures. The AAA offers a broad range of dispute resolution services to business executives, attorneys, individuals, trade associations, unions, management, consumers, families, communities, and all level of governments. The 198,491 cases composed of the 194,303 arbitration cases and the 4,188 mediation cases, were filed with the AAA in 2000. These case filings represent a full range of matters, including commercial finance, construction, labor and employment, environmental, health care, insurance, real state, securities, and technology disputes. The Korean Commercial Arbitration Board (KCAB) does more than render arbitration services. It helps facilitate settlements and guarantee implementation thereof between trading partners at home and abroad involving disputes related to such areas as the sale of commodities, construction, joint venture agreements, technical assistance, agency agreements, and maritime transport. The 643 cases composed of the the 197 arbitration cases and the 446 mediation cases, were filed with the KCAB in 2001. There are some differences between the AAA and the KCAB regarding the number and the area of mediation and arbitration case filings, the breath of service offerings, the scope of alternative dispute resolution, and the education and training. In order to apply to the proceedings of the commercial mediation and arbitration, the AAA has the Commercial Mediation Rules, the Commercial Arbitration Rules, the Expedited Procedures, the Optional Procedures for Large, Complex Commerical Dispute, and the Optional Rules for Emergency Measures of Protection as amended and effective on September 1, 2000. In order to apply to the proceedings of commercial arbitration, the KCAB has the Arbitration Rules as amended by the Supreme Court on April 27, 2000, which have been changed to incorporate the revisions of the Arbitration Act that went into effect on December 31, 1999. There are some differences between the AAA's commercial Arbitration Rules and the KCAB's Arbitration Rules regarding the clauses of jurisdiction and administrative conference, number of arbitrators, communication with arbitrator, vacancies, preliminary hearing, exchange of information, oaths, evidence by affidavit and posthearing filing of documents or others, interim measures, serving of notice, form of award, scope of award, delivery of award to parties, modification of award, release of liability, administrative fees, neutral arbitrator's compensation, and expedited procedures. In conclusion, for the vitalization of KCAB and its ADR system, the following measures should be taken : the effective case management, the development of on0-line ADR, the establishment of ADR system of electronic commerce disputes, and the variety of dispute resolution rules in each expert field.

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A Study on the Improvement of In-Home Care Service Quality through Evaluation of Services and Agency by Long-term Care Workers (요양보호사의 기관 및 서비스 평가를 통한 재가노인서비스 품질 향상 방안)

  • Bae, Hwa-Sook;Han, Jeong-Won
    • Journal of Digital Convergence
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    • v.14 no.10
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    • pp.71-81
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    • 2016
  • The objective of this study is to suggest methods to improve in-home service quality through service evaluation by long-term care workers. To achieve this objective, general characteristics of 223 long-term care workers, evaluation of service and agency, and retraining needs have been surveyed. An assessment of the survey results have resulted in the following conclusions. Though long-term care workers are not uneducated, the majority face unstable employment. And the content of supervision hoped for in producing improved long-term care services has been found to be based on the service-user's relationships. Moreover, among topics needing to be addressed for retraining, much attention has been shown for understanding of the elderly and their families, health care knowledge about geriatric diseases, and counseling techniques directed towards the affected person and their family. Findings from the research are as follow: enhancing the quality of long-term care requires a structural reassessment; upgrading the quality of care agencies requires the improvement of methods used to raise awareness of users and their guardians and the expansion of opportunities for education programs for professionalism.

Cost-benefit Analysis of Sodium Intake Reduction Policy in Korea (나트륨 섭취량 감소 정책의 비용편익 분석)

  • Lee, Chul-Hee;Kim, Dae-il;Hong, Jeong-Lim;Koh, Eun-Mi;Kang, Baeg-Won;Kim, Jong-Wook;Park, Hye-Kyung;Kim, Cho-Il
    • Korean Journal of Community Nutrition
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    • v.17 no.3
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    • pp.341-352
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    • 2012
  • It is well established that excessive sodium intake is related to a higher incidence of chronic diseases such as hypertension, stroke, coronary heart disease, cardiovascular disease and gastric cancer. Although the upper limit of the current sodium intake guideline by WHO is set at 2,000 mg/day for adults, sodium intake of Koreans is well over 4,700 mg/capita/day implying an urgent need to develop and implement sodium intake reduction policy at the national level. This study investigated the cost-effectiveness of the sodium intake reduction policy, for the first time, in Korea. Analyses were performed using most recent and representative data on national health insurance statistics, healthcare utilization, employment information, disease morbidity/mortality, etc. The socioeconomic benefits of the policy, resulting from reduced morbidity of those relevant diseases, included lower medical expenditures, transportation costs, caregiver cost for inpatients and income losses. The socioeconomic benefits from diminished mortality included reductions in earning losses and welfare losses caused by early deaths. It is estimated that the amount of total benefits of reducing sodium intake from 4.7 g to 3.0 g is 12.6 trillion Korean Won; and the size of its cost is 149 billion Won. Assuming that the effect of sodium intake reduction would become gradually evident over a 5-year period, the implied rate of average return to the sodium reduction policy is 7,790% for the following 25 years, suggesting a very high cost-effectiveness. Accordingly, development and implementation of a mid-to-long term plan for a consistent sodium intake reduction policy is extremely beneficial and well warranted.

Regional Differential Growth and Spatial Division of Labor in Producer Service Industries (생산자서비스 산업의 차별적 성장과 공무적 분업화에 관한 연구)

  • 이희연
    • Journal of the Korean Regional Science Association
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    • v.6 no.2
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    • pp.123-147
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    • 1990
  • This paper examines the changing geography of producer service industries in the 1980s. The foci of this study are to analyze the regional distribution of each producer services, and to reveal the spatial linkage of producer services. Further this paper asserts the potential role of producer services for reducing the potential endogenous development in the periphery. During the 1981-86 period, producer service industries grew more rapidly than other service sectors and manufacturing sector. The main reason of the raid growth of producer services is attributable to an increase in demand for intermediate services from manufacturing firms. In order to compete an increasingly complex business environment, firms have expanded the amount of effort devoted to activities such as planning, coordination and control, and consequently have increased their use of producer services. The most distinctive feature of the location of producer services is spatial concentration into Seoul and surrounding region. Especially the degree of the concentration o business services into the Capital Region has been accelerating during the 1990s. The pattern of employment growth and regional distribution of producer services show a clear core / periphery disparity. Much of the regional inequality in producer services is largely due to variation in demand associated with the pattern of corporation headquarters with the pattern of corporation headquarters and branch plants location with large manufacturing firms. The analysis of spatial division of labor reflects that producer services are related to the location of headquarters in manufacturing industry. Headquarters in manufacturing firms and business service firms tend to cluster each other. Most of the headquarters spatially separated from branch offices are clustered heavily in Seoul. Especially headquarters of business services and insurance services are overwhelmingly concentrated into Seoul. The firms whose headquarters are located in Seoul have a linkage pattern on a nationwide scale. It is viewed have little potential for generating local multiplier effects and regional development. In the light of the result of this study, producer services are not likely to disperse soon to peripheral regions. Consequently the absence of policies directed at enhancing producer sevice in the periphery, concentration tendency would continue to reinforce the core's dominance at the expense of peripheral regions. From a regional perspective, the quality of a region's producer service sector is a key determinant of economic growth, since manu industrial location decisions are influenced by the differential availability of producer services among regions. Poor performance of producer services in peripheral regions seemed to be linked to the region's manufacturing base. Low-wage, standardized branch plants are not likely to induce the growth in knowledge intensive services associated with high-technology corporate headquarters. Producer services may help to create and attract new business including manufacturing firms, and also to enhance the productivity and competitiveness of local firms. Therefore the provision of service producing activities would be lead not only to generate and retain endogenous development but also to attract external firms, especially small and medium sized firms which have a lower propensity of internalized services. Hence, it may be more efficient to create and expanse new locally owned producer services rather than to attract branch plants of mult-locational firms in order to make indigenous economic development.

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